E. coli outbreaks used to mainly be linked to hamburgers, but the last decade has seen recall after recall of tainted romaine lettuce coming into Canada from the United States. At least seven people have died, and hundreds have been sickened or hospitalized in both countries.
Toddler Lucas Parker was one of them.
In the fall of 2018, his parents, Nathan Parker and Karla Terry of Richmond, B.C., took Lucas and his siblings to Disneyland, their first trip outside Canada. But what they couldn’t know at the time was that a few bites of romaine salad Lucas ate one night at a small California roadside restaurant would change their lives forever.
Like most people who get sick from this strain of E. coli, Lucas, then two years old, didn’t show symptoms right away. When he started feeling unwell, the family headed out for the long drive home. By the time he was in a Canadian hospital, the E. coli had shut down one of his kidneys and led to two brain injuries. There are no current treatments for E. coli that can help alleviate infections or prevent complications.
Lucas can no longer walk, talk or see.
“Lucas was just a beaming ray of light … he was a caring person … a cheeky boy, a loving brother,” said his father, Nathan Parker. “I remember him in the hospital waking up out of a coma and looking around, just lost, not talking, not walking, not moving much. Such a brain injury that his brain was so swollen that there was no comfort, there was nothing. It was just hell.”
‘Most devastatingly injured human’
Bill Marler, an American lawyer and food-safety advocate who has been fighting for food safety for almost 30 years, represents Lucas and his parents. Marler has filed suit on behalf of the family against the restaurant where they ate, as well as the farm and suppliers of the lettuce; the case is currently in the discovery phase in a court system slowed down because of the COVID-19 pandemic.
Lucas, “is the most devastatingly injured human who has survived a food-borne illness outbreak — ever,” said Marler. “The fact that he survived at all and his parents care for him as gently and as caringly as they do is a testament to them.”
Young children and older adults are most at risk of developing serious complications from E. coli O157: H7 contamination. While most people simply experience an upset stomach, some develop life-threatening symptoms, including stroke, kidney failure and seizures — and some die.
Between 2009 and 2018, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) say they identified 40 food-borne outbreaks of infections from this strain of E. coli in the U.S. with a confirmed or suspected link to leafy greens.
Marler says he believes cows — and a society that values convenient, bagged lettuce — are to blame.
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Proximity of cattle
The vast majority of the romaine eaten in North America comes from lettuce grown in areas of California such as the Salinas Valley, or Yuma, Ariz. Many of those romaine lettuce fields have cattle nearby.
“We all know where E. coli O157: H7 comes from — it comes from cows,” said Marler. “And when you have a 100,000-cow feedlot, a dirt road, a canal and then leafy greens for as far as the eyes can see … it doesn’t take a rocket scientist to figure out what happened.”
The FDA says it is working to increase its understanding of how leafy greens become contaminated, and recent FDA reports suggest that cows near produce fields or water sources could be part of the problem. An FDA investigation revealed cattle feces found uphill from produce fields may have contributed to a fall 2020 outbreak, and FDA findings from a 2019 outbreak “suggests that a potential contributing factor has been the proximity of cattle to the produce fields.”
E. coli O157 lives in the intestines of healthy cattle and other animals, and can be found in water or soil that have been contaminated with animal feces.
The romaine lettuce that made Lucas sick came from a Santa Barbara, Calif., farm that may have had a contaminated water source. While it is not clear exactly how the water became contaminated, the FDA later noted “extensive wild animal activity” and cited adjacent land use by nearby cattle and horses “may have had the potential to be reservoirs of E. coli O157: H7.”
While the FDA hasn’t made new rules for lettuce growers, it has called on produce growers to prevent contamination by increasing buffer zones with nearby cattle, and to use other suggested strategies included in its 2020 Leafy Green STEC Action Plan, such as assessing risk to water sources and developing stronger traceability records.
John Boelts, a Yuma, Ariz.-based lettuce farmer, says food-borne illness outbreaks are not only extremely rare, but farmers like him are already doing more than what the FDA requires to keep the food supply safe.
“Farmers’ practices are remarkable these days, not just mine but everybody in my business,” Boelts said. “I think we’re doing everything humanly possible today.”
Like many lettuce farmers, Boelts does independent testing of the irrigation water surrounding his fields, and makes sure that irrigation water never touches the edible parts of his crops.
Boelts says he’s also taken steps to keep animals away, but he doesn’t believe having a cow feedlot nearby his fields is an issue.
“That feedlot has been around since the 1930s, 1940s and we’ve been producing leafy greens in this area for about that length of time,” Boelts said. “If there really was an issue we would be having an issue more frequently.”
Bagged salads spreading contamination, says Marler
Marler argues that convenient bagged salads have helped the spread of contaminated lettuce. One head of E. coli-contaminated lettuce can be cut, processed, mixed with other lettuce, and then cross-contaminate many different packages of bagged salads.
“The E. coli outbreaks linked to romaine lettuce and other leafy greens blew up in the last decade and a half because we wanted bagged salads,” he said. “We wanted to be able to go to the grocery store, restaurants wanted to be able to not have someone in the back chopping up lettuce, they just wanted to open a bag and dump it in your salad bowl and good to go…. It’s industrialized agriculture, convenience, and it’s killing us.”
Lawrence Goodridge, a professor of food safety at the University of Guelph in Ontario, agrees that the majority of E. coli lettuce outbreaks occur with bagged salads. He says that while E. coli outbreaks are actually quite rare, there are things that consumers should be doing, starting with avoiding prepackaged salads.
“To reduce the risk of developing a food-borne illness, consumers should purchase whole heads of lettuce and then remove the outer leaves,” Goodridge said. Consumers should also wash the inner leaves thoroughly. While buying head lettuce and washing it thoroughly won’t eliminate the risk of E. coli, Goodridge says it can help mitigate it.
The Canadian Food Inspection Agency (CFIA) says it can use a number of measures to assess if romaine lettuce imported from the United States is safe to eat for Canadians. The CFIA took steps to improve safety for Canadians last fall; importers had to show their lettuce was either free of E. coli or did not come from California’s Salinas Valley. Those measures never targeted lettuce from Yuma, Ariz., and have now since expired. The CFIA says it will reassess its rules later this year.
In Marler’s view, outbreaks will continue to happen if the source of the contamination isn’t addressed.
“These outbreaks will keep happening in Canada as well as the U.S. unless we deal with the environmental contamination caused by growing lettuce in close proximity to cattle,” he said.
Lucas Parker is now almost five years old. All his meals are liquified and ingested through a tube in his stomach.
“I ordered a salad. I thought I was doing the right thing, you know?” said Lucas’s father. “And because of a breakdown somewhere else it turned out to be the most fatal mistake in the world.”
He thinks not enough people know about the potential dangers of E. coli-contaminated romaine lettuce.
“I want people to be made aware that anything, you know, should never be taken for granted — because you could eat something that can just take your life away, take your joy away.”
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Pakistan says trial of Chinese traditional medicine for COVID-19 successful
Pakistani health authorities on Monday announced the completion of a successful clinical trial of Chinese traditional herbal medicine for treating COVID-19, as the South Asian nation enters a fifth wave of the pandemic driven by the Omicron variant.
The Chinese medicine, Jinhua Qinggan Granules (JHQG) manufactured by Juxiechang (Beijing) pharmaceutical Co Ltd, is already being used in treatment of COVID-19 patients in China.
“Since it was tried on patients with different variants of COVID-19, we expect it to be effective on Omicron as on other variants,” Professor Iqbal Chaudhry, director of the International Center for Chemical and Biological Science (ICCBS) where trials were conducted, told reporters.
The trials were conducted on 300 patients who were treated at home, and would work on mild to moderate COVID-19 cases, Dr Raza Shah, principal investigator in the trials, told reporters, adding that the efficacy rate was around 82.67%.
The trials were approved by the Drug Regulatory Authority Pakistan.
Pakistan reported 4,340 COVID-19 cases on Monday, the highest recorded in a 24-hour period in three months. Karachi, the country’s largest city, recorded a positivity rate – the percentage of tests coming back positive – of 39.39% at the weekend, the highest so far.
“In the last seven days, COVID cases in Pakistan have increased by 170% while deaths have also increased by 62%,” the National Command Operation Centre (NCOC), which is overseeing the pandemic response, said in a tweet on Monday.
(Reporting by Syed Raza Hassan; Editing by Alex Richardson)
How (and why) to 'green' your Mediterranean diet – The Globe and Mail
A Mediterranean diet has been tied to better cognitive function, a lower rate of cognitive decline and a reduced risk of Alzheimer’s disease.
This eating pattern, plentiful in fruits and vegetables, whole grains, nuts and olive oil, has also been associated with lower rates of age-related brain atrophy, brain damage which can lead to cognitive impairment and dementia.
So far, though, there’s sparse data from randomized controlled trials on whether following a Mediterranean diet can preserve brain volume.
New research from Israel has shown that eating a Mediterranean diet slowed the age-related loss of brain tissue. What’s more, a new take on the diet, a “green” Mediterranean diet, had even greater brain-health benefits.
The latest study
The 18-month DIRECT PLUS trial, published Jan. 10 in the American Journal of Clinical Nutrition, investigated the effect of a high-polyphenol Mediterranean diet (a “green” Mediterranean diet) on age-related brain atrophy.
Polyphenols are naturally occurring compounds found in a wide range of plant foods. DIRECT PLUS stands for Dietary Intervention Randomized Controlled Trial – Polyphenols Unprocessed.
The researchers assigned 284 adults with abdominal obesity, average age 51, to one of three diet groups: 1) healthy diet guidelines, 2) a Mediterranean diet or, 3) a higher-polyphenol green Mediterranean diet.
Both Mediterranean diets were calorie-restricted and included 28 g of walnuts (e.g., 14 walnut halves), nuts high in polyphenols.
To boost polyphenols, the green Mediterranean diet included four to five cups of green tea daily and a green shake containing Mankai, a branded strain of an aquatic plant called duckweed (or water lentils). Those in the green Mediterranean diet group also further reduced their intake of processed and red meat.
All participants received free gym memberships and a program of aerobic and resistance exercise.
Participants underwent brain MRI (magnetic-resonance-imaging) scans before and after the trial. Specific areas of the brain were measured as indicators of brain atrophy and predictors of future dementia risk.
Over 18 months, participants in both Mediterranean diet groups had a significantly lower decline in brain atrophy compared to the healthy diet guideline group. The greatest decline in brain tissue loss, however, was observed among those consuming the green Mediterranean diet, especially in people over age 50.
The green Mediterranean diet components – green tea, Mankai and walnuts – were each associated with reduced brain atrophy, as was eating less red and processed meat.
Participants in both Mediterranean diet groups also had improvements in insulin sensitivity, which was also tied to less brain volume loss.
The study didn’t show a significant effect of either Mediterranean diet on cognition, perhaps because the study wasn’t long enough and/or it involved relatively young and healthy people.
All diet groups participated in physical exercise, which may have contributed to the slowdown of brain atrophy.
The strengths of this study include participants high adherence to their diets and that, to date, it’s the longest and largest brain MRI study investigating the effect diet on brain atrophy.
How polyphenols protect the brain
The beneficial effect of the Mediterranean diet on brain aging is thought to be due, at least in part, to its abundance of polyphenols, phytochemicals which have antioxidant and anti-inflammatory properties.
Polyphenols can cross the blood-brain barrier and have been shown to reduce nerve cell inflammation and stimulate an increase in brain cells.
Eating a Mediterranean diet rich in fish, vegetables and olive oil is also thought to protect the brain from a buildup of proteins that form plaques and destroy brain cells.
‘Greening’ your Mediterranean diet
Following a Mediterranean eating pattern means including vegetables, fruit, whole grains, pulses, nuts and olive oil in your daily diet.
Limit red meat to three meals a week. The green Mediterranean diet limits meat even further, getting more protein from beans, lentils and nuts. Flavour meals with polyphenol-rich herbs and spices.
Build on these staples by adding more polyphenol-rich foods to your daily diet, including 28 g of walnuts. Drink three or four cups of green tea each day (white and oolong tea also have polyphenols).
Drinking a Mankai green shake may be more challenging, though, at least for Canadians. In the U.S., frozen cubes of Mankai duckweed are sold online through Amazon and WW (Weight Watchers). Mankai duckweed powder is also available online.
Add other polyphenol-rich foods to your diet, too, such as berries, apples, kale, broccoli, spinach, cocoa, tofu, edamame, flaxseed and pecans.
Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD
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Moderna CEO says data for Omicron-specific shot likely available in March
Moderna Inc’s vaccine candidate against the Omicron coronavirus variant will enter clinical development in the next few weeks and the company expects to be able to share data with regulators around March, CEO Stephane Bancel said on Monday.
“The vaccine is being finished … it should be in the clinic in coming weeks. We are hoping in the March timeframe to be able to have data to share with regulators to figure out next steps,” Bancel said at the World Economic Forum’s virtual Davos Agenda conference.
Moderna is also developing a single vaccine that combines a booster dose against COVID-19 with its experimental flu shot. (https://reut.rs/3FAeyya)
Bancel said the best case scenario was the combined COVID/flu vaccine would be available by the fall of 2023, at least in some countries.
“Our goal is to be able to have a single annual booster so that we don’t have compliance issues where people don’t want to get two to three shots a winter.”
Many countries are already offering a third dose of a COVID-19 vaccine to their citizens, especially to older individuals and those who are immunocompromised, while Israel has started offering its citizens a fourth dose.
Earlier in January, Moderna’s CEO said people may need a fourth shot in the fall of 2022 as the efficacy of boosters against COVID-19 was likely to decline over the next few months.
However, booster programs have met with skepticism from some disease experts over whether, and how widely, additional doses should become available, including the European Union’s drug regulator, which has expressed doubts about the need for a fourth booster dose.
Speaking at the same event, top U.S. infectious disease expert Anthony Fauci said there was no evidence that repeat booster doses would overwhelm the immune system.
“Giving boosters at different times, there is really no evidence that’s going to hinder (immune response).”
Fauci said the goal should be to have a booster that induces a response against multiple potential variants.
(Reporting by Mrinalika Roy in Bengaluru; Editing by Mark Potter)
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